Optimizing the Options When You're Uninsured

CURE, Spring 2013, Volume 12, Issue 1

Solutions are available to uninsured and cash-strapped patients.

Patients living without insurance run the risk of incurring high medical bills that can easily leave them financially devastated. Patients who are uninsured or will be losing their insurance coverage may find the following resources beneficial to help them get the care and treatment they need:

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Disability and Medicaid: Many patients with an advanced cancer diagnosis may qualify for expedited approval into a federal disability program through the Compassionate Allowances classification. If approved, this may serve as a qualifier for Medicaid insurance. Medicaid programs are available even for patients who exceed the income and asset requirement, but because Medicaid is administered by individual states, it’s best to check with state offices. Apply regardless, as this is often a requirement when applying for other assistance programs.

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HRSA Health Centers: Health Resources and Services Administration (HRSA) health centers will provide care even if a patient has no health insurance. Fees for medical services are based on the patient’s income. Health centers and free clinics can be an effective means of accessing medical and dental care, and are located in most cities and many rural areas.

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Clinical Trials: A clinical trial is a type of research study that uses volunteers to test new methods of preventing, screening, diagnosing or treating a disease. Clinical trials can provide access to new treatments, as many trials absorb most or all of the research—but not standard care—costs, although this can vary trial by trial.

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Nonprofit and Charity Organizations: Numerous advocacy and disease-specific nonprofit organizations serve local, regional or national groups of cancer patients. Many of these programs offer grants to help patients in need. Assistance is available in a range of areas, including housing, utilities, medications, doctor co-pays, food, scholarships, transportation and childcare during treatment.

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Medication Assistance: Most drug manufacturers have an array of assistance programs, coupons and discounts that may offer qualified individuals free or low-cost medications, including chemotherapy. Patients can also speak to their doctor about lower cost and comparable medication alternatives, generic brands, bulk discounts and access to medication samples to ease the burden of cost.

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Charity Care/Discounts: Patients who have been treated at a medical facility, hospital emergency room or urgent care center and are now responsible for a large amount of debt should speak to the billing representative about charity programs, affordable payment plans, self-pay discounts or other financial assistance. Patients should initiate this conversation without assuming the billing representative will volunteer the information.

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Risk Pool and Pre-Existing Condition Coverage: Patients who can afford some form of insurance should ask about specialty insurance plans that provide coverage for those who were previously considered too high-risk to qualify. Most patients need to be uninsured for at least six months prior to be eligible for these discounted rates.

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Manage Costs During Treatment: Patients who will be paying out of pocket for the costs of their treatment should ask questions and talk to their doctors about specific treatment or testing options. Less expensive options may be available at outside facilities, including: walk-in retail clinics, ambulatory surgery centers, outpatient services, or stand-alone imaging and blood diagnostic facilities.

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Apply for Local Medical Assistance: Apply for a local city or county medical assistance program. These are not available in every location. However, where available, they provide a coordinated system specifically for uninsured residents to access needed medical care on a sliding scale or at a lower cost within their local community.

Erin Moaratty is chief of mission delivery for the Patient Advocate Foundation (patientadvocate.org).